Oncotarget

Research Papers:

RIC versus MAC UCBT in adults with AML: A report from Eurocord, the ALWP and the CTIWP of the EBMT

Frédéric Baron _, Annalisa Ruggeri, Eric Beohou, Myriam Labopin, Guillermo Sanz, Noel Milpied, Mauricette Michallet, Andrea Bacigalupo, Didier Blaise, Jorge Sierra, Gérard Socié, Jan J. Cornelissen, Christoph Schmid, Sebastian Giebel, Norbert-Claude Gorin, Jordi Esteve, Fabio Ciceri, Bipin N. Savani, Mohamad Mohty, Eliane Gluckman and Arnon Nagler

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Oncotarget. 2016; 7:43027-43038. https://doi.org/10.18632/oncotarget.9599

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Abstract

Frédéric Baron1,*, Annalisa Ruggeri2,3,*, Eric Beohou4, Myriam Labopin4, Guillermo Sanz5, Noel Milpied6,7 Mauricette Michallet8, Andrea Bacigalupo9, Didier Blaise10, Jorge Sierra11, Gérard Socié12, Jan J. Cornelissen13, Christoph Schmid14, Sebastian Giebel15, Norbert-Claude Gorin3,4, Jordi Esteve16, Fabio Ciceri17, Bipin N. Savani18, Mohamad Mohty3,19,20, Eliane Gluckman21 and Arnon Nagler4,22

1 University of Liege, Liege, Belgium

2 Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, Paris, France

3 AP-HP, Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France

4 EBMT Paris Office, Hospital Saint Antoine, Paris, France

5 Hospital Universitario La Fe, Servicio de Hematologia, Valencia, Spain

6 CHU Bordeaux, Hématologie Clinique et Thérapie Cellulaire-Hôpital Haut-leveque, Bordeaux, France

7 University of Bordeaux, Bordeaux, France

8 Service d’ Hematologie du Centre Hospitalier de Lyon Sud, Pierre-Bénite, France

9 Ospedale San Martino, Department of Haematology II, Genova, Italy

10 Institut Paoli Calmettes (IPC), Aix Marseille University (AMU), UM105, Centre de Recherche en Cancerologie (CRCM), Inserm U1068, CNRS UMR7258 Marseille, Marseille, France

11 Hospital Santa Creu i Sant Pau, Hematology Department, Barcelona, Spain

12 AP-HP, Hematology Transplantation, Hospital Saint-Louis, Paris, France

13 Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands

14 Klinikum Augsburg, Department of Hematology and Oncology, University of Munich, Augsburg, Germany

15 Maria Sklodowska-Curie Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland

16 Deptartment of Hematology, Hospital Clinic, Barcelona, Spain

17 Department of Hematology, Ospedale San Raffaele, Università degli Studi, Milano, Italy

18 Long Term Transplant Clinic, Vanderbilt University Medical Center, Nashville, TN, USA

19 Universite Pierre & Marie Curie, Paris, France

20 INSERM, UMRS 938, Paris, France

21 Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Monacord, Centre Scientifique de Monaco, Monaco

22 Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel

* These authors have contributed equally to the paper

Correspondence to:

Frédéric Baron, email:

Keywords: unrelated cord blood, AML, reduced-intensity, myeloablative, transplantation

Received: May 02, 2016 Accepted: May 14, 2016 Published: May 26, 2016

Abstract

Nonrelapse mortality (NRM) is the first cause of treatment failure after unrelated cord blood transplantation (UCBT) following myeloablative conditioning (MAC). In the last decade, reduced-intensity conditioning (RIC) regimens have been developed with the aim of reducing NRM and allowing older patients and those with medical comorbidities to benefit from UCBT. The aim of the current retrospective study was to compare transplantation outcomes of acute myeloid leukemia (AML) patients given UCBT after either RIC or MAC. Data from 894 adults with AML receiving a single or double UCBT as first allograft from 2004 to 2013 at EBMT centers were included in this study. 415 patients were given UCBT after RIC while 479 patients following a MAC. In comparison to MAC recipients, RIC recipients had a similar incidence of neutrophil engraftment and of acute and chronic graft-versus-host disease (GVHD). However, RIC recipients had a higher incidence of disease relapse and a lower NRM, translating to comparable leukemia-free (LFS), GVHD-free, relapse-free survival (GRFS) and overall survival (OS). These observations remained qualitatively similar after adjusting for differences between groups in multivariate analyses. In conclusion, these data suggest that LFS and OS are similar with RIC or with MAC in adults AML patients transplanted with UCBT. These observations could serve as basis for a future prospective randomized study.


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